INCIDENCE AND PREDICTORS OF ABNORMAL RENAL FUNCTION THREE MONTHS AFTER DELIVERY AMONG PRE-ECLAMPSIA SURVIVORS AT MULAGO HOSPITAL
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Background Pre-eclampsia, a leading contributor to maternal mortality, is a common pregnancy specific hypertensive disorder with multisystem involvement including the renal system. The impact of pre-eclampsia on the kidneys of the survivors can subsequently lead to the development of abnormal renal function after delivery, culminating later into chronic kidney disease. The aim of this study was to establish the incidence and predictors of abnormal renal function three months after delivery among pre-eclampsia survivors at Mulago hospital. Methods This was a prospective cohort study at Mulago hospital involving 116 pre-eclampsia survivors. Clinical and laboratory data were collected at delivery and three months after delivery. Proportion of pre-eclampsia survivors with abnormal renal function was determined by the number of survivors with diminished estimated glomerular filtration rate of less than 90 ml/min/1.73m² using CKD-EPI equation. Logistical regression analyses were performed to determine the predictors of abnormal renal function three month after delivery. Results A high incidence of abnormal renal function after three-months of 16.7% was found. Delivery of a male baby, adjusted OR 7.232 (CI 1.534-34.094), p-value = 0.012 and persistence of hypertension three months after delivery, adjusted OR 6.267 (CI 1.021-17.828), p-value = 0.032 were independent statistically significant predictors of abnormal renal function three months after delivery. Conclusions and recommendations A significant proportion of women have abnormal renal function three months after a pregnancy complicated by pre-eclampsia requiring prolonged follow up. Follow up of such women should be extended beyond the universal three months postpartum for all mothers. This will identify mothers most at risk of developing chronic kidney disease and ensure early intervention to delay disease progression. This will contribute to strategies to reduce the burden of chronic kidney disease.